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Original research
Duration of neonatal oxygen supplementation, erythropoiesis and blood pressure in young adults born preterm
  1. Adrien Flahault1,
  2. Camille Girard-Bock1,
  3. Rafael Oliveira Fernandes1,
  4. Anik Cloutier1,
  5. Yves D Pastore1,2,
  6. Thuy Mai Luu1,3,
  7. Anne Monique Nuyt1,4
  1. 1 Sainte-Justine University Hospital Research Center, University of Montreal, Montreal, Québec, Canada
  2. 2 Division of Hematology and Oncology, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
  3. 3 Division of General Pediatrics, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
  4. 4 Division of Neonatology, Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Québec, Canada
  1. Correspondence to Dr Anne Monique Nuyt, Sainte-Justine Hospital Pediatric Research Centre, Montreal, H3T 1C5, Canada; anne.monique.nuyt{at}


Background Although erythropoiesis is impaired and anaemia frequent in neonates born preterm, haematopoiesis in adults born preterm has not been previously studied.

Objective We, thus, aimed to evaluate haemoglobin and erythropoietin levels in young adults born preterm, to identify neonatal events associated with erythropoiesis in adulthood and to examine the relationships of haemoglobin levels with respiratory function and blood pressure.

Methods We assessed a cohort of 101 young adults (ages 18–29) born preterm (≤29 weeks of gestation), in comparison to 105 full-term controls. We measured haemoglobin, erythropoietin levels and blood pressure. We also assessed respiratory function using spirometry.

Results Compared with controls, tobacco use and sex-adjusted haemoglobin levels were 5.3 (95% CI 2.9 to 7.7) g/L higher in preterm-born individuals, but erythropoietin levels were similar. Duration of oxygen supplementation in the neonatal period was independently associated with higher haemoglobin levels in the preterm group. In young adults born preterm with bronchopulmonary dysplasia, airflow limitation was associated with higher haemoglobin levels. Both systolic (SBP) and diastolic (DBP) blood pressure were increased in individuals born preterm (p=0.042 and p=0.0008, respectively). Higher haemoglobin levels were associated with higher SBP and DBP, independently of term or preterm status. Mediation analysis suggests that haemoglobin increase contributes to 37% and 32% of the effect of preterm birth on SBP and DBP, respectively.

Conclusions Haemoglobin levels are higher in young adults born preterm, while erythropoietin levels are similar, especially in case of bronchopulmonary dysplasia and airflow limitation, and haemoglobin increase is associated with elevated blood pressure in this population.

  • paediatric lung disaese
  • critical care

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  • Contributors TML and AMN conceived the HAPI study and obtained the funding. AF, TML and AMN designed and performed the analysis, and wrote the paper. AF, CG-B, ROF and AC collected the data. YDP participated to the interpretation of the results. All authors revised the manuscript.

  • Funding This work was supported by the Canadian Institutes of Health Research (CIHR 133572 to AMN and TML), the Canada Foundation for Innovation (to AMN) and the Fondation CHU Sainte-Justine (to AMN), a Fonds de recherche du Québec-Santé (FRQS) salary award to TML, a FRQS/Fondation des Étoiles fellowship award to AF and a FRQS and Canadian Vascular Network student awards to CG-B.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval Ethics approval was obtained from the participating hospitals Research Ethics Boards.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

  • Author note 140-character Tweet: Increased haemoglobin levels in adults born preterm linked to bronchopulmonary dysplasia and blood pressure.

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